What Obama Means for Health Information Technology

Kathryn Mackenzie, for HealthLeaders Media, November 11, 2008

Well, it's finally over. The 21-month long saga that culminated one week ago today in Barack Obama being chosen as America's next president. Even as his supporters were celebrating victory, President-elect Obama wasted no time getting down to business. By Friday, he had already chosen several key members of his transition team, including two technology advisers: Washington technology policy expert Julius Genachowski, an Internet business veteran and former executive of Barry Diller's IAC/InterActiveCorp.; and Sonal Shah, a tech executive from Google's philanthropy division, Google.org.

Obama's choice of two technology experts to help guide his transition into office has bolstered his previous assertion that technology will play a major role in the new administration. And Obama has made it clear that health information technology will play a central role in his plan to overhaul the health system.

His plan is to invest $10 billion a year over the next five years to promote broad adoption of standards-based electronic health information systems, including electronic health records. He also plans to phase in requirements for full implementation of health IT and appoint the nation's first chief technology officer (rumor has it that appointment could be made as early as tomorrow) to coordinate the government's technology infrastructure, work on issues of transparency, and "employ technology and innovation to solve our nation's most pressing problems," according to Obama's Web site.

The big question now is how and when Obama will put such an ambitious (and expensive) plan into action, especially given the country's economic problems.

Blair Childs, senior vice president of public affairs at Premier Inc., says that he expects to see a number of healthcare initiatives enacted as soon as 2009, including a realignment of the payment system to incentivize quality and efficiency.

"Despite everything else that is happening, I still expect to see a huge amount of focus on healthcare in 2009. There is also a lot that is going to be decided over the next month with the three Senate seats. If the Democrats get those three seats, or even two of them, they will certainly have an easier path toward getting a bill done," says Childs. Though Democrats made several gains in the 100-seat Senate, the fate of three seats remains to be determined.

We have seen some movement toward paying providers for adopting e-health initiatives. Beginning in January, CMS will implement an electronic prescribing incentive program for physicians, which will increase Medicare payments by 2% for doctors who use the technology. While that program is a step in the right direction, it will take many more like it to get providers to invest in expensive electronic systems, says Childs.

The primary goal of the Obama healthcare plan is to increase access to care and decrease healthcare costs. And while health information technology will play a central role in reaching both of those goals, it certainly won't be without some considerable obstacles, says Ned Moore, CEO at Portico Systems.

"If we cover all of the uninsured, that is going to mean there will be an additional 47 million people eligible for health insurance. You can imagine the impact that will have on the system infrastructure. Before that happens we need better, faster, more tech-enabled solutions in place," says Moore.

Though Moore emphasizes that there is not one solution to ensure the infrastructure can withstand such a massive influx of new members and new claims, health plans should begin looking now at what systems they have in place, and how much those systems can handle, he says. On the provider side, he says, CIOs may want to be asking themselves if there is some technology you can invest in to streamline operations, knowing you could have a surge of volume in the near future.

"We've just got to be pushing the idea that everything will be digital, everything will be electronic. Web-based systems are going to have a very integral role in what I believe will be an evolutionary process," says Moore.

I think that everyone can agree that when he takes office in January, Obama will have three main priorities: the economy, the war, and healthcare. What I've been hearing in the early days after the election is that we can expect a phased in approach to the changes he has planned. Most industry experts also believe that it will be technology that will play the biggest role in increasing access and decreasing costs. And finally, as Childs says, if healthcare information technology is going to live up to its potential in the coming years, the payment system is going to have to be revisited and revised to incentivize those investing in it.

Kathryn Mackenzie is technology editor of HealthLeaders magazine. She can be reached at kmackenzie@healthleadersmedia.com.
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